Active NPI
Samuel Berlin
- Day Training/Habilitation Specialist
- Bethel, AK
National Provider Identifier
1902108103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- Practice address
- 700 Chief Eddie Hoffman Highway
Bethel, AK 99559 - Phone
- (907) 543-6300
- Fax
- (907) 543-6366
- NPI assigned
- Nov 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Day Training/Habilitation Specialist | 373H00000X | Primary | ||
| Personal Care Attendant | 3747P1801X |
Addresses
Primary practice location
700 Chief Eddie Hoffman Highway
Bethel, AK 99559
Mailing address
P.O. Box 287
Yukon Kuskokwim Health Corporation
Bethel, AK 99559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1902108103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 287",
"address_2": "YUKON KUSKOKWIM HEALTH CORPORATION",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 CHIEF EDDIE HOFFMAN HIGHWAY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6300",
"fax_number": "907-543-6366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLIN",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-22",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": true
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.